ObjectiveTo analyze the trend of hospital infection, so as to provide a scientific basis for hospital infection prevention and control. MethodsFrom 2011 to 2013, according to the criteria of diagnosis of nosocomial infections set up by the Ministry of Health, the prevalence rates of nosocomial infections in patients who were hospitalized on the survey day were investigated by the combination of bedside investigation and medical records checking. ResultsThe incidence rates of nosocomial infections from 2011 to 2013 were 2.99%, 2.31% and 1.95%, respectively, presenting a downward trend. The rate of hospital infection was the highest in comprehensive Intensive Care Unit, and the main infection site was the lower respiratory tract. Gram-negative bacteria were the main pathogens causing hospital infections, including Klebliella pnermoniae, Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter baumannii and Escherichia coli. The utilization rates of antibacterial agents in these three years were respectively 39.84%, 34.58% and 34.22%. ConclusionTargeted surveillance and management of key departments and sites should be strengthened. It is necessary to strengthen the surveillance and management of antibiotics, raise the submission rate of pathogens, and use antibiotics appropriately.
Objective To systematically review the impact of Beijing's comprehensive reform of medical consumption linkage on medical expenses, hospital services, and hospital income. Methods Databases including CNKI, WanFang Data, VIP, CBM, PubMed, and Web of Science were searched to collect empirical research on evaluating the impact of Beijing's comprehensive reform of medical consumption linkage on patient medical expenses and hospital operation (service volume and income structure) from June 15th, 2019 to August 15th, 2021. A descriptive analysis was performed after two reviewers independently screened the literature and extracted data. Results A total of 23 studies were included, and most of them found a relatively small change in the average outpatient and emergency medical expenses after the reform. However, the average inpatient expenses in some hospitals showed an increasing trend; the service volume of most hospitals increased slightly, and the income structure was optimized (e.g., surgery and other medical technology services revenue and its proportion increased). Conclusion The comprehensive reform of the medical consumption linkage in Beijing is the practice of deepening the reform of the medical service price mechanism. Based on the summary of the reform effect, it is recommended to further improve the price mechanism, improve service quality, and promote hierarchical diagnosis and treatment.
ObjectiveTo explore the risk factors for surgical patients associated with postoperative nosocomial infection through monitoring the infection conditions of the patients, in order to provide a scientific basis for the development of hospital infection control measures in a second-grade class-A hospital in Chengdu City. MethodsWe conducted the survey with cluster sampling as the sampling method and the uniform questionnaire in the departments of orthopedic, neural and thoracic surgery from July 2011 to June 2012. The main parameters we observed were the patients'general and surgical conditions, antibiotics usage and hospital infection situation. Data were analyzed using the National Nosocomial Infection Surveillance Network software and chi-square test of single factors. ResultsIn this survey, we monitored 50 cases of postoperative hospital infection. The infection rate was 7.73% and the highest infection rate was in the Neurosurgery Department. The main site of infection was lower respiratory tract, followed by surgical site. The different usage time of antimicrobial drug in perioperative period resulted in different infection rates, and the difference was statistically significant (χ2=601.50, P<0.005). The rate of adjusted postoperative hospital infection was higher than pre-adjusted rate except that of the neurosurgery doctor 4. The risk factors associated with hospital postoperative infection in our hospital were:patients'conditions including underlying disease, emergency surgery, type of anesthesia, operative duration, hospital stay and postoperative drainage. Most of the hospital infection cases were caused by bacteria of the gram-negative bacilli, and the major pathogens were Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii in our hospital. ConclusionThe hospital should particularly strengthen the prevention and control of hospital infection in patients after neurosurgical operations. For patients with basic diseases, we should actively improve the patients'physical conditions before operation and control the primary lesion. Targeted control measures should be taken for different factors related to surgery. Reasonable selection of antimicrobial agents should be based on the epidemic strains in our hospital.
目的 了解医院感染情况，对医院感染控制工作进行评价，为医院感染控制措施提供依据，提高医务人员的感染控制意识。 方法 采用横断面调查的方法，于2012年8月21日进行医院感染现患率调查，将调查结果进行分类、统计、分析。 结果 应查住院患者1 383例，实查1 378例，实查率99.64%，现患率3.41%。医院感染下呼吸道感染占53.19%，泌尿道感染占25.53%，手术部位感染占4.26%，调查当日抗菌药物使用率20.90%。 结论 通过医院感染现患率调查，可快捷地获得全院医院感染的情况，为医院感染防控工作提供依据。
目的 分析胃肠外科手术切口感染的影响因素，为医院感染的防治提供理论依据。 方法 回顾性分析2010年12月－2012年12月764例行胃肠外科手术患者的临床资料，并用单因素χ2检验统计分析患者医院感染的危险因素。 结果 共有65例患者发生手术切口感染，其感染率为8.5%，且分离培养出合格菌株48株，阳性率73.8%，其中G−菌32株，占66.7%，G+菌16株，占33.3%。G−菌主要以大肠杆菌、变形杆菌、克雷伯杆菌和肠杆菌为主，分别占29.2%、18.8%、12.5%和6.2%；G+菌以肠球菌和表皮葡萄球菌为主，分别占22.9%和10.4%。单因素χ2检验显示年龄＞60岁、手术时间＞120 min、术中有输血、且有肿瘤病变的患者具有较高的切口感染发生率（P＜0.05）。 结论 胃肠外科手术切口感染的主要致病菌是G−杆菌，患者的年龄、手术时间、术中输血情况和疾病良恶性质是术后切口感染的高危因素，积极采取相应的预防措施有望减低其感染的发生率。
In recent years, along with more importance having been given by health care facilities and health administrative departments nationally, the work force of infection prevention and control is constantly increasing. In the new era, to help infection prevention and control practitioners and all health care workers make the right direction in infection prevention and control professional business and make sure the infection prevention and control measures are implemented, what we need is to define the target of infection prevention and control scientifically, identify obligation subjects, and improve the infection prevention and control system and working mechanism from the top-level.
At present, balanced scorecard is widely used in hospital performance management, but because of the difficulty in selecting indicators and the ambiguity of causality, its implementation on the application level is limited. Based on the theory of “competitive advantage” and resource arrangement, this study constructs an improved balanced scorecard index system for discipline performance evaluation from the perspective of improving discipline competitiveness of Ningbo No.2 Hospital. The index system mainly includes the dimensions of discipline quality development, resource allocation efficiency and so on, with the characteristics of “focusing on advantages, accurate positioning” and innovation, and has achieved good results in practical application.